Cases top 50,000 in Africa’s mpox outbreak

Last week African countries reported 2,532 new mpox cases, mostly in the Democratic Republic of the Congo (DRC) and Burundi, pushing the total since the first of the year to 50,840 cases, officials from Africa Centres for Disease Control and Prevention (Africa CDC) said today.

The officials also reported 32 more deaths from the virus. At the briefing, Jean Kaseya, MD, MPH, Africa CDC’s director-general, said cases continue to rise in Uganda and the outbreak has spread to one more district of Central African Republic (CAR), Paoua, which is on the border with Chad.

Progress with testing, but challenges remain

Rwanda, after going 4 weeks with no new cases, reported 20 more, which, according to Ngashi Ngongo, MD, PhD, leader of Africa CDC’s mpox incident management team, reflects a testing backlog. The country has also been battling a Marburg virus outbreak.

Countries are making progress, especially with testing. And those that have started vaccine campaigns are reporting good uptake. 

Officials said, however, that a remaining challenge is immunization hasn’t yet started for children, one of the hardest-hit groups, because of regulatory and supply issues. Currently, the Bavarian Nordic Jynneos vaccine is recommended for adolescents and adults only. Kaseya said Africa CDC is still working with Japan on a plan to receive about 3 million doses of the LC16 vaccine, which the country used in the 1970s to vaccinate young children.

Rwanda and the DRC, the two countries that have started vaccinating, have met or passed their vaccine targets. Nigeria’s campaign was slated to begin on October 29, but due to logistical issues is now expected to launch on November 18.

Kaseya urged countries outside of Africa to follow through on their pledges of support. He noted that the United States has pledged 1 million vaccine doses and $500 million to support the outbreak response. He said he looks forward to continuing talks with the United States and its incoming administration about strategic health relationships. 

Vaccine allocation takes shape

In related developments, Africa CDC and its partners, including the Coalition for Epidemic Preparedness Innovations (CEPI), Gavi, UNICEF, and the World Health Organization, yesterday announced that the 899,000 doses of mpox vaccine has been allocated for nine countries.

In a joint statement, the groups said the allocation mechanism is designed to ensure that limited doses are used efficiently and fairly. The nine countries are the CAR, Ivory Coast, the DRC, Kenya, Liberia, Nigeria, Rwanda, South Africa, and Uganda, with 85% earmarked for the DRC, the hardest-hit country. The vaccines came from Canada, Gavi, the European Union, and the United States.

More than 5.85 million doses are expected by the end of the year.

Vaccine trial planned for pregnant women, babies

Meanwhile, CEPI today announced $8.1 million to support a first-of-its-kind safety and immunogenicity trial of Jynneos in pregnant and breastfeeding women, as well as in children younger than 2 years old. The group noted that Global Health EDCTP3 is providing part of the support.

The trial is slated to begin in the DRC in the first part of 2025, with a goal of enrolling 350 pregnant women and 250 babies and toddlers. 

CEPI said the data could help expand vaccine access in the groups, who are known to be at increased risk for complications but who aren’t yet eligible for vaccination.